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Red Cross Health Equipment Loan Program (HELP)
Larger items (hospital beds, lifts e.g.) only available at HELP Plus sites
(cm):
(kg):
Family Doctor:
inches
inches
inches
inches
inches
inches
inches
inches
inches
inches
inches
inches
"Electronically signed"
Doctor
Other
OT
PT
RN
Subject:
Red Cross Health Equipment Loan Program (HELP) eForm, update V7_Jan28_2021, by Dr. John Yap, is licensed under a
GPL
.
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